stroke.org.uk

Stroke for employers

A complete guide to

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If you have an employee who is coming back to work after a stroke, then this guide can help you prepare for their return.

It will tell you about stroke, the changes it can cause and how they can affect someone in the workplace. It also tells you how best to support someone when they are ready to return to work.

This guide is aimed at employers but there may be information that’s useful for stroke survivors and their families as well.

We have information on all aspects of stroke.

If you have a question that is not answered in this guide visit stroke.org.uk or call our Stroke Helpline on 0303 3033 100.

Please note: while we’ve made every effort to provide the best possible, up-to-date and relevant information this is not intended to be an exhaustive guide. It should not be relied upon as a substitute for professional, specialist advice including advice regarding your legal obligations as an employer or otherwise.

This guide has been produced by the Stroke Association’s London-wide Back to Work project. This project is part funded by City Bridge Trust and fundraising by Team Sky, headed up by international rugby star, Michael Lynagh.

The development of this guide was part funded by the NHS Lothian Health Promotion Service. The Stroke Association retains independent editorial control over all content.

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What is a stroke?

A stroke is a brain attack. It happens when the blood supply to part of your brain is cut off. Blood carries essential nutrients and oxygen to your brain. Without blood your brain cells can be damaged or die.

Strokes affect people in different ways, depending on the part of their brain that is damaged. A stroke can affect the way your body functions as well as your thought processes and how you feel and communicate.

Stroke occurs approximately 152,000 times a year in the UK; that’s one every 3 minutes and 27 seconds. It is also the biggest cause of complex disability in the world – over half of stroke survivors have a disability and need support.

Many people think that strokes only happen to older people but stroke can strike anyone at any time. Younger people can have strokes too, including babies and children.

One in four strokes in the UK happen in people of working age. With the right support and guidance many people successfully return to work after a stroke.

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A stroke can dramatically change someone’s life and your employee will need your support. They may be experiencing emotional, mental or physical changes. They may also be worrying about their financial situation and find themselves navigating an unfamiliar benefits system.

Here are our golden rules to help you support them the best you can.

Timing is importantOften people just want to get back to ‘normal’ after a stroke, so it can be tempting to rush back to work. But if people return to work before they or their employers are ready, it can lead to problems further down the line. On the other hand, too much of a delay can affect someone’s confidence and make it more difficult when they do come back.

The best thing to do is to stay in touch with your employee and plan for their return together. This will help you understand what support they need and give you time to put it in place before they come back, which should make it much easier for both of you.

Ask the expertEvery stroke survivor is an expert in their own needs. So don’t be afraid to ask your employee about the best way for you to support them.

Start by being open and supportive. Let them know that their needs are important. And keep talking. It can take time to become aware of all the different changes that happen after a stroke. So your employee may not have all the answers straight away and things are likely to change as time goes on.

ListenIt’s really important to set up clear, open channels of communication with your employee as soon as possible, so you can understand how their stroke has affected them. Listen without judgment to what they tell you. Ask questions to make sure you understand and have all the information you need.

Don’t make assumptionsNo two strokes are the same, just like no two people are the same. Some people will have visible disabilities (such as problems walking) but for others their disabilities may not be visible (such as problems with concentration). These ‘hidden’ disabilities can make it difficult to know that someone needs support. That’s why it’s important to ask and listen.

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Our golden rules for employers

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“I only work a couple of hours a day while I ease back into work, but I’m hoping to increase this in time. It’s a huge sense of achievement to be back.”

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Respect their privacyBe sensitive to your employee’s right to privacy. They may not wish to disclose their disabilities or the fact they have had a stroke. Ask them if they would like to let other colleagues know and if so, who. Then decide together the best way to do this.

Check guidelines and agreementsFind out if your organisation has policies in place for long-term illness or absence. Familiarise yourself with these and speak to the relevant teams in your organisation such as Human Resources and Occupational Health for additional guidance.

Check to see what financial support your employee is entitled to receive, such as sickness pay. Make sure you give information as promptly as you can, so your employee has enough time to respond, and present it in a way that is clear, honest and easy to understand.

Ask about supportYour employee may be able to get financial or practical support via Access to Work (see page six).

Your employee may also be receiving support from an NHS occupational therapist (OT) who can help them decide when they are ready to return to work. Your employee may be able to put you in touch with their occupational therapist, so they can help you understand how the stroke has affected your employee and answer any questions you may have.

Create a Return to Work PlanArrange ways to keep in touch while your employee is away from work. Once they are ready, meet to create a plan for returning to work. This can include the number of days they will work each week and how many hours each day.

Most people find that a phased return (see page six), which allows them to gradually build up to their previous working hours, helps them to get used to working again.

You should also review the tasks that they do and any changes that need to be made to them. It’s also a good opportunity to update your employee on any team or organisational changes that may have happened whilst they’ve been away from work.

Trial and reviewYour employee’s needs are likely to change as their recovery continues. Set regular times to review the arrangements you’ve agreed. Be honest about what is or isn’t working and encourage your employee to do the same. Try to be as flexible and creative as you can.

Be flexibleIt’s likely that your employee will continue to have appointments with health professionals once they return to work. You should try to allow time off for these appointments as they will be an essential part of their recovery.

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a reasonable adjustment?

The Equality Act 2010 states that a disability should not stop someone from working or having the same rights and access to opportunities as other people.

As an employer you have a duty to make reasonable adjustments for employees who are disabled. These are alterations to the workplace or the way a disabled person does their job in order to allow them to work. This may mean changing their work times or providing specialist equipment to help them with certain tasks.

Other examples of reasonable adjustments are: • reducing or amending duties and

targets• arranging work shadowing or ‘buddying

up’ with a colleague• adapting equipment or making other

changes to the work environment• working from a different location or

from home.

Reasonable adjustments do not have to be expensive or complicated. It’s about looking at the barriers a person is experiencing and thinking creatively about removing them. Allow time to make sure reasonable adjustments can be made before your employee returns to work.

The adjustments you can make will also depend on the size and finances of your organisation. So it may be that you can’t accommodate all the adjustments your employee needs. However, with an open and collaborative approach you’ll be able to decide together what adjustments you can realistically and fairly make. Employees cannot be made to pay for reasonable adjustments.

More information about your duties as an employer under the law and about protecting your staff from disability-based discrimination can be found here:www.equalityhumanrights.com/private-and-public-sector-guidance/employing-people/guidance-employers

a phased return?

This means that your employee would return to work on a part-time basis and gradually build up their hours. So your employee could initially return for four hours a day, two days a week, for example, and increase their hours from there. It may take time to return to the amount of hours they were working before, so try to be as flexible as you can.

Many people find a phased return helps them readjust to working again. It could also have benefits for you, as it gives you the chance to see what’s working and assess any changes that may be needed.

Access to Work?

This is a UK government scheme that provides practical advice and support for disabled people and their employers to allow them to find or stay in work. It offers an initial workplace assessment, where an adviser can look at the workplace and the tasks that your employee needs to do. They will then make recommendations for additional support that could help.

This could be adapted equipment, coaches to work one-to-one on things like building memory strategies or a support worker to assist with basic manual tasks. The scheme can also help with transport to work. See Other people that can help (page nine) for contact details.

What is...

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How well someone recovers from a stroke depends on many factors, including how quickly their stroke was treated and the support and therapy they received afterwards. People can make excellent recoveries and even if they’re left with problems, these can continue to improve over time.

Over the next two pages you’ll find a brief guide to some of the problems that your employee may be coping with and how you can help. It’s important to remember that everyone’s experience of stroke is different. So the best way to understand how your employee has been affected is to ask them.

Communication problems

Some stroke survivors experience speech and language problems. It can include difficulties with speaking and understanding what people are saying. It can also affect reading and writing. This is called aphasia.

How can you help?• If your employee is having difficulty

speaking, you need to give them time. Try not to interrupt, with enough time they’ll be able to answer for themselves.

• Remember that your employee’s intelligence has not been affected, just their ability to use and understand language.

• Read our leaflet Communication problems after stroke for more tips and advice.

Cognitive problems

A stroke can affect the way your brain understands, organises and stores information. This can make it difficult to concentrate, remember things or solve problems. Problems with concentration and short-term memory are especially common after a stroke.

How can you help?• Written instructions or a reference

guide could be useful for someone who has short-term memory problems. Instructions for using the phone or the photocopier, for example, could be helpful, so that your employee doesn’t feel they have to keep asking the same question.

• Keep verbal or written instructions clear and concise and try not to overload them with too much information at once.

• Reducing distractions and allowing for regular breaks can often help to improve concentration.

“Even though people at work have heard the word stroke, they didn’t really know about the different types of effects a stroke can have. Afterreading this guide I really felt they understood my hidden disability better.”

The effects of stroke

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Emotional changes

A stroke is sudden and shocking, and affects every part of your life. It’s a lot to deal with, and everyone deals with it differently. The anxiety and frustration that is causes can sometimes make people feel that they’re unable to cope.

How can you help?• Frequent reviews will help both you and

your employee. This will allow you to catch issues early on and implement any changes that are needed.

• Check to see if your organisation can offer any counselling or emotional support.

• Encourage your employee to talk to their GP about emotional support and counselling or find out about services they can refer themselves to. Our Stroke Helpline can tell them more.

Physical effects

A stroke can have any number of physical effects. It can cause weakness or loss of movement in an arm, leg or down one whole side of the body. As well as affecting someone’s mobility, this can also cause a great deal of pain. A stroke can also affect vision, balance and coordination.

How can you help?• You may need to make some adaptations

to your employee’s work space – they may need a more supportive chair, for example.

• Make sure that the things they need are within easy reach and that there is plenty of room to move around, to minimise the risk of falling.

• If they are having problems with their vision, then they may need written information provided in a different way.

“The difference in mypartner since he went back to work has been amazing. His confidence has improved since finding work again.”

Tiredness

Many people have problems with fatigue after a stroke. This isn’t like typical tiredness, it doesn’t always improve with rest and it isn’t related to how busy or active you’ve been.

How can you help?• Regular breaks may help your employee to

manage their tiredness. A later start time can also be helpful.

• Read our leaflet Fatigue after stroke for more tips and advice.

There are effects of stroke you can’t seeAlthough your employee may look physically fine, they could still be coping with other difficulties like cognitive problems or emotional changes. Very often people aren’t aware of these effects until they are back at work.

The best thing to do is to have open, regular communication. Some stroke survivors struggle to talk about their difficulties or may not wish to, so you’ll need to be as supportive and patient as you can. Ask questions and encourage your employee to do the same.

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Where can I get help and support?

How we can help

Our Stroke Helpline can give you information and support. Whatever your question, we’re here to help. We also have lots of information about stroke and its effects on our website.

We can help you to raise awareness of stroke, with information sessions for your staff. We can also organise a Know Your Blood Pressure event at your workplace. These are informal, fun events that take people’s blood pressure and inform them about what they can do to reduce their risk of stroke.

To find out how we can help, just get in touch:• Call our Stroke Helpline on 0303 3033 100 • Email info@stroke.org.uk• Visit stroke.org.uk

Our Back to Work Project works with both employers and employees who are based in London, to make sure that stroke survivors stay in work, make the best possible recovery and continue to develop.

We can offer guidance and advice and employees can access one-to-one tailored support and workshops on confidence building and stress relief.

If you are based in London contact Kate Pieroudis, our Back to Work Project Manager:• email kate.pieroudis@stroke.org.uk• call her on 020 7940 1353 or 07702

976569.

Other people that can help Below are some organisations in the UK that can provide further information and advice. Contact our Stroke Helpline if you’d like to know about others in your area.

The Equality and Human Rights Commission has information for employers about your duties under the law and making reasonable adjustments.

Website: www.equalityhumanrights.com/private-and-public-sector-guidance/employing-people/work-place-adjustments

There may be additional considerations that public sector employers in Scotland need to consider.

Website: www.equalityhumanrights.com/about-us/devolved-authorities/commission-scotland/public-sector-equality-duty-scotland/public-authorities-scotland-who-covered-specific-duties-0

Access to Work can provide advice and support for both you and your employee. If you are in England, Scotland or Wales your employee will need to contact them first to find out if they are able to apply.

Access to Work (England, Scotland, Wales)Website: www.gov.uk/access-to-workEmail: atwosu.london@dwp.gsi.gov.ukTelephone: 0345 268 8489 Textphone: 0345 608 8753

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There is a different Access to Work scheme in Northern Ireland. To apply your employee will need to speak to an Employment Service Adviser at their local Jobs and Benefits Office or JobCentre.

Access to Work (Northern Ireland)Website: www.nidirect.gov.uk/access-to-work-practical-help-at-work

Disability Rights UK has information about benefits and government schemes that are available. It also provides disability confidence training for employers.

Website: www.disabilityrightsuk.org Telephone: 020 7250 8181Email: enquiries@disabilityrightsuk.org

Fit for Work is a free advice and assessment service for supporting employees, employers and GPs to manage a return to work.

Fit for Work (England and Wales)Website: fitforwork.orgAdviceline: 0800 032 6235 0800 032 6233 (Cymraeg) Fit for Work (Scotland)Website: fitforworkscotland.scotAdviceline: 0800 019 2211

Headway is a charity for people who have had a brain injury. They have information about returning to work for employees and employers.

Website: www.headway.org.ukHelpline: 0808 800 2244 (Mon–Fri, 9am–5pm)Email: helpline@headway.org.uk

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About our information

We want to provide the best information for people affected by stroke. That’s why we ask stroke survivors and their families, as well as medical experts, to help us put our publications together.

How did we do?

To tell us what you think of this guide, or to request a list of the sources we used to create it, email us at feedback@stroke.org.uk

We are the Stroke Association We believe in life after stroke. That’s why we support stroke survivors to make the best recovery they can. It’s why we campaign for better stroke care. And it’s why we fund research to develop new treatments and ways of preventing stroke. We’re here for you. If you’d like to know more, please get in touch.

Stroke Helpline: 0303 3033 100Website: stroke.org.ukEmail: info@stroke.org.ukFrom a textphone: 18001 0303 3033 100

Stroke Association is a Company Limited by Guarantee, registered in England and Wales (No 61274). Registered office: Stroke Association House, 240 City Road, London EC1V 2PR. Registered as a Charity in England and Wales (No 211015) and in Scotland (SC037789). Also registered in Northern Ireland (XT33805) Isle of Man (No 945) and Jersey (NPO 369).

© Stroke Association 2015Version 1 Published: March 2015. Next review: March 2016.

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Together we can conquer stroke

The Stroke Association is a charity. We rely on your support. Text STROKE 5 to 70300 to donate £5. 100% of your donation goes to the Stroke Association. Find out how your support helps at stroke.org.uk/savelives